The Experts below are selected from a list of 423 Experts worldwide ranked by ideXlab platform
Lino Rossi - One of the best experts on this subject based on the ideXlab platform.
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Enhanced A-V nodal conduction (Lown-Ganong-Levine Syndrome) by congenitally hypoplastic A-V node
European Heart Journal, 1992Co-Authors: R. Ometto, Gaetano Thiene, Domenico Corrado, M. Vincenzi, Lino RossiAbstract:The basic anatomical substrate of enhanced A-V nodal conduction, manifesting or not as Lown-Ganong-Levine Syndrome, is still a controversial issue. We describe the case of a 34-year-old man who presented episodes of ventricular fibrillation. Electrophysiological studies showed that the AH interval was 55 ms, and increased by only 20 ms at paced cycle lengths of 300 ms; atrial pacing induced atrial fibrillation, with a shortest RR interval of 240 ms. Despite verapamil therapy, this patient died suddenly at home. Histological study disclosed a severe A-V node hypoplasia that was evidently congenital in nature; the rest of the conduction system was normal, and no accessory A-V pathways were present. We suggest that enhanced A-V nodal conduction in this patient was due to the developmental defect in the A-V node; this abnormality caused a loss of specific impulse-delaying function, and thus allowed rapid, unfiltered atrial impulses to reach the lower A-V junction and ventricles.
Samik Wahab, Samik A. A. Wahab - One of the best experts on this subject based on the ideXlab platform.
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Supravengricular tachycardia in children: The role of infectious diseases and its relationship to serum enzyme
Journal of the Medical Sciences (Berkala Ilmu Kedokteran), 2015Co-Authors: Samik Wahab, Samik A. A. WahabAbstract:In twenty four children an episode of supraventricular tachycardia occurred before 15 years (median age 12 months). Fourteen male and 10 female children were reviewed, of which one had a congenital heart disease. Lown-Ganong-Levine Syndrome was present on surface ECG in 1/24 (4 per cent). Forty six per cent of children were undernourished as determined by the weight to height ratio according to the WHO criteria (1983), and 58 per cent of them were anemic, according to the WHO criteria (1972). All children have had fever, mostly above 38.5° C. In ten children with an SVT episode the serum enzyme level, was also studied, i. e. the serum glutamine oxalo-transaminase (SCOT), lactate dehydrogenase (LDH) and creatinine phosphokinase (CPK). Five out of 11 children had a high serum enzyme level, ranging 25-68 U/dI (mean: 40.88 ± 16.30) for GOT, 315 889 U/dI (mean: 482 ± 232.53) for LDH, and 57-581 U/d1 (mean: 251.33 ± 287.02) for CPK, instead of a normal level range of 1-19 U/c11, 80-240 U/dl and 0-50 U/dl respectively. It is concluded that the episode of SVT often occurs in children with infection, especially gastrointestinal intention, meningitis, encephalitis. bronchopneumonia and septicemia. Fever, undernutrition and anemic status are considered as precipitating factors. Preexitation Syndromes, such as WPW and LGL Syndromes, were infrequently found. Digitalis treatment has to be changed with other preparations which are often used such as calcium antagonist or ATP, especially for patients who do not respond to digitalis. Physicians who work in the surgery department, should be aware of an SVT episode, especially if the children have fever, undernutrition and anemia. Key Words: supraventricular tachycardia - anemia - undernutrition - WPW Syndrome - LGL syndrom
A. Samik Wahab - One of the best experts on this subject based on the ideXlab platform.
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Supravengricular tachycardia in children: The role of infectious diseases and its relationship to serum enzyme
Journal of the Medical Sciences, 2015Co-Authors: A. Samik WahabAbstract:In twenty four children an episode of supraventricular tachycardia occurred before 15 years (median age 12 months). Fourteen male and 10 female children were reviewed, of which one had a congenital heart disease. Lown-Ganong-Levine Syndrome was present on surface ECG in 1/24 (4 per cent). Forty six per cent of children were undernourished as determined by the weight to height ratio according to the WHO criteria (1983), and 58 per cent of them were anemic, according to the WHO criteria (1972). All children have had fever, mostly above 38.5° C. In ten children with an SVT episode the serum enzyme level, was also studied, i. e. the serum glutamine oxalo-transaminase (SCOT), lactate dehydrogenase (LDH) and creatinine phosphokinase (CPK). Five out of 11 children had a high serum enzyme level, ranging 25-68 U/dI (mean: 40.88 ± 16.30) for GOT, 315 889 U/dI (mean: 482 ± 232.53) for LDH, and 57-581 U/d1 (mean: 251.33 ± 287.02) for CPK, instead of a normal level range of 1-19 U/c11, 80-240 U/dl and 0-50 U/dl respectively. It is concluded that the episode of SVT often occurs in children with infection, especially gastrointestinal intention, meningitis, encephalitis. bronchopneumonia and septicemia. Fever, undernutrition and anemic status are considered as precipitating factors. Preexitation Syndromes, such as WPW and LGL Syndromes, were infrequently found. Digitalis treatment has to be changed with other preparations which are often used such as calcium antagonist or ATP, especially for patients who do not respond to digitalis. Physicians who work in the surgery department, should be aware of an SVT episode, especially if the children have fever, undernutrition and anemia. Key Words: supraventricular tachycardia - anemia - undernutrition - WPW Syndrome - LGL Syndrome
Primossi G - One of the best experts on this subject based on the ideXlab platform.
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Ventricular pre-excitation: electrophysiopathology, criteria for interpretation and clinical diagnosis. References for geriatrics
Minerva cardioangiologica, 2001Co-Authors: Fontanelli A, Primossi GAbstract:The authors review the state-of-the-art on ventricular pre-excitation in medical and arrhythmological literature in order to facilitate the recognition of the various clinical forms, like classic and occult Wolff Parkinson withe Syndrome and Lown Ganong Levine Syndrome. A historical introduction reviews our electrophysiopathological knowledge of the electrical activation and conduction of ventricular pre-excitation compared to normal, starting from the anatomic discovery of conduction pathways to the possible use of transesophageal electrostimulation and endocavity mapping to study electric potentials. Avantgarde technologies have also been developed to eliminate anomalous pathways firstly by using a direct current dirscharge and secondly radiofrequency. Atrioventricular electric activation has been widely illustrated in normal subjects in order to create a model for comparison with pathological ventricular pre-excitation: the upper left portion of the septum is no longer the first zone to trigger the kinetic mechanism compared to the early fascicular fraying of the homonymous branch. Instead the upper right part of the septum is activated earlier owing to the anomalous fascia connected on this side to the right branch through their septal arborisations. As a result, this new conduction pathway activates the ventricular masses earlier through an anomalous route, given that there is no further contact with the atrioventricular nodes which act as a control. A similar situation is found in the left branch block where the ventriculogram is late with a normal PR, unlike pre-excitation when an early delta wave is present with a short PR. Electric conduction is also illustrated based on new knowledge of the circuit structures and the rings theory. Orthodromic tachycardia is distinguished from the antidromic form, double accessory pathway tachycardia, ectopic reciprocant atrial fibrillation tachycardia and occult bundle tachycardia which is studied using transesophageal stimulation with a time threshold of 70 ms for ventricular-atrial retrograde activation. The stimulation techniques using single or repeated extrastimulus are explained for this purpose, as well as those with serial extrastimulation and the physical characteristics of the circuit based on the ratio between voltage and resistance. The authors also report the practical aims of electrostimulation for determining the electric threshold of the anomalous circuit in terms of refractoriness, electric atrial stability, reciprocity and the occurrence of the macro re-entry. Lastly, the authors describe electric conduction by anomalous pathways based on the criterion of conduction and activation, both of which are analysed and compared on the basis of the intrinsicoid deflection morphology on the surface ECG: the aberrant qRs usually suggests an antidromic ventricular activation and retrograde conduction between atrium and ventricle, while normal intrinsicoid deflection demonstrates that the activation is orthodromic and the conduction anterograde, namely ventricle-atrial. Having been reproduced in a synoptic synthesis, these manifestations show a regular electrophysiological pattern because they are dissimilar from the behaviour of the monophasic bioelectric potential of the cardiac cells specialised in the conduction of the stimulus, whether they represent a normal or pathological electric pathway. The study is rounded off by the analysis of the reciprocant tachycardias and their re-entry varieties related to the type of the anomalous bundles. A number of types of re-entry can be identified: sinusal re-entry (micro re-entry), atrial re-entry, re-entry in the atrio-ventricular node, re-entry tachycardia and the so-called triggered type. The discussion of the electrophysiopathological aspects of pre-excitation is followed by the clinical forms of ventricular pre-excitation that can be divided into 3 main types. The different ECG clinical pictures are set out in the summary table, together with the type of shunt and activation and possible variants, following Rosenbaum s classic paint: the common type B, the rare type A and a last variant, the C type. This section also describes the positional peculiarities of the Kent-Paladino bundle, the left ventricular, septal (anterior and posterior) and the multiple-bundle ones. The authors also illustrate the criterion and meaning of endocavity mapping in the search for anomalous bioelectric potentials that identify the pathway or the location of the endocardiac bundle and/or foci to be eliminated. A new echocardiographic technique is described with a conventional M mode, digitalised 2D and tissular Doppler which has a comparable ability to identify the anomalous pathways of electric conduction using a non-invasive method. (ABSTRACT TRUNCATED)
Neslihan Altunkaya - One of the best experts on this subject based on the ideXlab platform.
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Anesthesia management in cesarean section with lown ganong levine Syndrome
Medicine Science | International Medical Journal, 2018Co-Authors: Duygu Demiroz Aslan, Fusun Adam, Neslihan AltunkayaAbstract:Lown Ganong Levine (LGL) which is a preexcitation Syndrome is defined with paroxysmal tachycardia, dyspnea, anxiety, angina, and the complaint of fatigue accompanied by characteristic changes on ECG (short PR). Herein, we present a case of cesarean which we completed with a low-dose spinal anesthesia without problem, avoiding from general anesthesia which could be induced with numerous arrhythmogenic drugs, because of arrhythmia complication which might be mortal.
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Anesthesia management in cesarean section with lown ganong levine Syndrome
Society of TURAZ AKADEMI, 2018Co-Authors: Duygu Demiroz Aslan, Fusun Adam, Neslihan AltunkayaAbstract:Lown Ganong Levine (LGL) which is a preexcitation Syndrome is defined with paroxysmal tachycardia, dyspnea, anxiety, angina, and the complaint of fatigue accompanied by characteristic changes on ECG (short PR). Herein, we present a case of cesarean which we completed with a low-dose spinal anesthesia without problem, avoiding from general anesthesia which could be induced with numerous arrhythmogenic drugs, because of arrhythmia complication which might be mortal. [Med-Science 2018; 7(4.000): 951-2
